References of "Boly, Mélanie"
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See detailA french validation study of the Coma Recovery Scaled-Revised (CRS-R)
Schnakers, Caroline ULg; Majerus, Steve ULg; Giacino, Joseph et al

in Brain Injury (2008), 22(10), 786-792

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See detailWhat is it like to be vegetative or minimally conscious?
Laureys, Steven ULg; Boly, Mélanie ULg

in Current Opinion in Neurology (2007), 20(6), 609-613

Purpose of review Patients in a vegetative or minimally conscious state continue to pose problems in terms of diagnosis, prognosis and treatment. Despite recent waves of international media attention ... [more ▼]

Purpose of review Patients in a vegetative or minimally conscious state continue to pose problems in terms of diagnosis, prognosis and treatment. Despite recent waves of international media attention following Terri Schiavo's death and the 'miracle recovery' of Terry Wallis, research efforts aimed at increasing our knowledge about brain function in these conditions remain scarce and must address a series of difficulties, including financial and ethical barriers. Here we review current possibilities and limitations of clinical and para-clinical assessment of chronic disorders of consciousness. Recent findings During the past year the field has witnessed publication of significant, yet isolated, case reports in top-ranking journals, including Science and Nature. Such milestone reports and other impressive recent technological advances in the study of vegetative and minimally conscious patients reveal enthralling areas of science that must find their way to clinical medical reality. Summary Consciousness is a subjective experience whose study has remained within the purview of philosophy for millennia. That has finally changed, and empirical evidence from functional neuroimaging offers a genuine glimpse at a solution to the infamous mind-body conundrum. New technological and scientific advances offer the neurological community unique ways to improve our understanding and management of vegetative and minimally conscious patients. [less ▲]

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See detailBaseline brain activity fluctuations predict somatosensory perception in humans
Boly, Mélanie ULg; Balteau, Evelyne ULg; Schnakers, Caroline ULg et al

in Proceedings of the National Academy of Sciences of the United States of America (2007), 104(29), 12187-12192

In perceptual experiments, within-individual fluctuations in perception are observed across multiple presentations of the same stimuli, a phenomenon that remains only partially understood. Here, by means ... [more ▼]

In perceptual experiments, within-individual fluctuations in perception are observed across multiple presentations of the same stimuli, a phenomenon that remains only partially understood. Here, by means of thulium-yttrium/aluminum- garnet laser and event-related functional MRI, we tested whether variability in perception of identical stimuli relates to differences in prestimulus, baseline brain activity. Results indicate a positive relationship between conscious perception of low-intensity somatosensory stimuli and immediately preceding levels of baseline activity in medial thalamus and the lateral frontoparietal network, respectively, which are thought to relate to vigilance and "external monitoring." Conversely, there was a negative correlation between subsequent reporting of conscious perception and baseline activity in a set of regions encompassing posterior cingulate/ precuneus and temporoparietal cortices, possibly relating to introspection and self-oriented processes. At nociceptive levels of stimulation, pain-intensity ratings positively correlated with baseline fluctuations in anterior cingulate cortex in an area known to be involved in the affective dimension of pain. These results suggest that baseline brain-activity fluctuations may profoundly modify our conscious perception of the external world. [less ▲]

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See detailWhen thoughts become action: An fMRI paradigm to study volitional brain activity in non-communicative brain injured patients
Boly, Mélanie ULg; Coleman, M. R.; Davis, M. H. et al

in NeuroImage (2007), 36(3), 979-992

The assessment of voluntary behavior in non-communicative brain injured patients is often challenging due to the existence of profound motor impairment. In the absence of a full understanding of the ... [more ▼]

The assessment of voluntary behavior in non-communicative brain injured patients is often challenging due to the existence of profound motor impairment. In the absence of a full understanding of the neural correlates of consciousness, even a normal activation in response to passive sensory stimulation cannot be considered as proof of the presence of awareness in these patients. In contrast, predicted activation in response to the instruction to perform a mental imagery task would provide evidence of voluntary task-dependent brain activity, and hence of consciousness, in non-communicative patients. However, no data yet exist to indicate which imagery instructions would yield reliable single subject activation. The aim of the present study was to establish such a paradigm in healthy volunteers. Two exploratory experiments evaluated the reproducibility of individual brain activation elicited by four distinct mental imagery tasks. The two most robust mental imagery tasks were found to be spatial navigation and motor imagery. In a third experiment, where these two tasks were directly compared, differentiation of each task from one another and from rest periods was assessed blindly using a priori criteria and was correct for every volunteer. The spatial navigation and motor imagery tasks described here permit the identification of volitional brain activation at the single subject level, without a motor response. Volunteer as well as patient data [Owen, A. M., Coleman, M.R., Boly, M., Davis, M.H., Laureys, S., Pickard J.D., 2006. Detecting awareness in the vegetative state. Science 313, 1402] strongly suggest that this' paradigm may provide a method for assessing the presence of volitional brain activity, and thus of consciousness, in non-communicative brain-injured patients. (c) 2007 Elsevier Inc. All rights reserved. [less ▲]

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See detailfMRI study of hypnosis-induced analgesia
Boly, Mélanie ULg; Balteau, Evelyne ULg; Schnakers, Caroline ULg et al

in Journal of Neurology (2007, May), 254(Suppl. 3), 38-39

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See detailCerebral resting state fluctuations predict somatosensory perception
Boly, Mélanie ULg; Balteau, Evelyne ULg; Schnakers, Caroline ULg et al

in Journal of Neurology (2007, May), 254(Suppl. 3), 42

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See detailLocked-in syndrome et états de conscience altérée: comment détecter la conscience?
Vanhaudenhuyse, Audrey ULg; Bruno, Marie-Aurélie ULg; Schnakers, Caroline ULg et al

in Pellas, Frederique; Kiefer, C; Weiss, JJ (Eds.) et al Eveil de coma et états limites (2007)

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See detailDetecting consciousness in minimally conscious patients
Vanhaudenhuyse, Audrey ULg; Schnakers, Caroline ULg; Boly, Mélanie ULg et al

in Réanimation (2007), 16

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See detailEvaluation comportementale et par neuroimagerie fonctionnelle des patients en état végétatif
Vanhaudenhuyse, Audrey ULg; Schnakers, Caroline ULg; Boly, Mélanie ULg et al

in Revue Médicale de Liège (2007), 62 Spec No

Currently, there remains a high rate of misdiagnosis of the vegetative state. This should incite clinicians to use the most sensitive "coma scales" to detect signs of consciousness in these patients. The ... [more ▼]

Currently, there remains a high rate of misdiagnosis of the vegetative state. This should incite clinicians to use the most sensitive "coma scales" to detect signs of consciousness in these patients. The gold standard remains the Glasgow Coma Scale (GCS, Teasdale and Jennet, 1974), with the Glasgow Liege Scale (GLS, Born, 1988) adding standardized assessment of brainstem reflexes. New sensible behavioral assessment tools for use in the acute neurocritical care setting include the Full Outline of UnResponsiveness (FOUR, Wijdicks et al., 2005). The Coma Recovery Scale-Revised (CRS-R, Giacino and Kalmar, 2004) specifically tests the diagnostic criteria differentiating vegetative from minimally conscious patients. Detecting signs of consciousness also depends on the employed methodology. We showed that for the assesment of the presence of visual pursuit, using a moving mirror is better suited than using a moving object or person. The clinical diagnosis can be confirmed by cerebral positron emission tomography studies objectively quantifying residual metabolic activity in vegetative and minimally conscious patients. Ongoing studies evaluate the prognostic value of functional magnetic resonance imaging studies in these challenging patient populations. [less ▲]

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See detailSleep transforms the cerebral trace of declarative memories
Gais, Steffen; Albouy, Geneviève ULg; Boly, Mélanie ULg et al

in Proceedings of the National Academy of Sciences of the United States of America (2007), 104(47), 18778-18783

After encoding, memory traces are initially fragile and have to be reinforced to become permanent. The initial steps of this process occur at a cellular level within minutes or hours. Besides this rapid ... [more ▼]

After encoding, memory traces are initially fragile and have to be reinforced to become permanent. The initial steps of this process occur at a cellular level within minutes or hours. Besides this rapid synaptic consolidation, systems consolidation occurs within a time frame of days to years. For declarative memory, the latter is presumed to rely on an interaction between different brain regions, in particular the hippocampus and the medial prefrontal cortex (mPFC). Specifically, sleep has been proposed to provide a setting that supports such systems consolidation processes, leading to a transfer and perhaps transformation of memories. Using functional MRI, we show that postlearning sleep enhances hippocampal responses during recall of word pairs 48 h after learning, indicating intrahippocampal memory processing during sleep. At the same time, sleep induces a memory-related functional connectivity between the hippocampus and the mPFC. Six months after learning, memories activated the mPFC more strongly when they were encoded before sleep, showing that sleep leads to long-lasting changes in the representation of memories on a systems level. [less ▲]

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See detailNaloxone-insensitive epidural placebo analgesia in a chronic pain patient.
Kupers, Ron; Maeyaert, Jan; Boly, Mélanie ULg et al

in Anesthesiology (2007), 106(6), 1239-42

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See detailHemodynamic cerebral correlates of sleep spindles during human non-rapid eye movement sleep.
Schabus, Manuel ULg; Dang Vu, Thien Thanh ULg; Albouy, Geneviève ULg et al

in Proceedings of the National Academy of Sciences of the United States of America (2007), 104(32), 13164-9

In humans, some evidence suggests that there are two different types of spindles during sleep, which differ by their scalp topography and possibly some aspects of their regulation. To test for the ... [more ▼]

In humans, some evidence suggests that there are two different types of spindles during sleep, which differ by their scalp topography and possibly some aspects of their regulation. To test for the existence of two different spindle types, we characterized the activity associated with slow (11-13 Hz) and fast (13-15 Hz) spindles, identified as discrete events during non-rapid eye movement sleep, in non-sleep-deprived human volunteers, using simultaneous electroencephalography and functional MRI. An activation pattern common to both spindle types involved the thalami, paralimbic areas (anterior cingulate and insular cortices), and superior temporal gyri. No thalamic difference was detected in the direct comparison between slow and fast spindles although some thalamic areas were preferentially activated in relation to either spindle type. Beyond the common activation pattern, the increases in cortical activity differed significantly between the two spindle types. Slow spindles were associated with increased activity in the superior frontal gyrus. In contrast, fast spindles recruited a set of cortical regions involved in sensorimotor processing, as well as the mesial frontal cortex and hippocampus. The recruitment of partially segregated cortical networks for slow and fast spindles further supports the existence of two spindle types during human non-rapid eye movement sleep, with potentially different functional significance. [less ▲]

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See detailSleep-related hippocampo-cortical interplay during emotional memory recollection.
Sterpenich, Virginie ULg; Albouy, Geneviève ULg; Boly, Mélanie ULg et al

in PLoS Biology (2007), 5(11), 282

Emotional events are usually better remembered than neutral ones. This effect is mediated in part by a modulation of the hippocampus by the amygdala. Sleep plays a role in the consolidation of declarative ... [more ▼]

Emotional events are usually better remembered than neutral ones. This effect is mediated in part by a modulation of the hippocampus by the amygdala. Sleep plays a role in the consolidation of declarative memory. We examined the impact of sleep and lack of sleep on the consolidation of emotional (negative and positive) memories at the macroscopic systems level. Using functional MRI (fMRI), we compared the neural correlates of successful recollection by humans of emotional and neutral stimuli, 72 h after encoding, with or without total sleep deprivation during the first post-encoding night. In contrast to recollection of neutral and positive stimuli, which was deteriorated by sleep deprivation, similar recollection levels were achieved for negative stimuli in both groups. Successful recollection of emotional stimuli elicited larger responses in the hippocampus and various cortical areas, including the medial prefrontal cortex, in the sleep group than in the sleep deprived group. This effect was consistent across subjects for negative items but depended linearly on individual memory performance for positive items. In addition, the hippocampus and medial prefrontal cortex were functionally more connected during recollection of either negative or positive than neutral items, and more so in sleeping than in sleep-deprived subjects. In the sleep-deprived group, recollection of negative items elicited larger responses in the amygdala and an occipital area than in the sleep group. In contrast, no such difference in brain responses between groups was associated with recollection of positive stimuli. The results suggest that the emotional significance of memories influences their sleep-dependent systems-level consolidation. The recruitment of hippocampo-neocortical networks during recollection is enhanced after sleep and is hindered by sleep deprivation. After sleep deprivation, recollection of negative, potentially dangerous, memories recruits an alternate amygdalo-cortical network, which would keep track of emotional information despite sleep deprivation. [less ▲]

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See detailThe role of sleep in the consolidation of emotional memories in humans: a fMRI study
Sterpenich, Virginie ULg; Albouy, Geneviève ULg; Boly, Mélanie ULg et al

in Journal of Sleep Research (2006, September), 15(Suppl. 1), 190

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See detailDetecting Awareness in the Vegetative State
Owen, Adrian; Coleman, Martin; Boly, Mélanie ULg et al

in Science (2006)

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See detailTracking the recovery of consciousness from coma
Laureys, Steven ULg; Boly, Mélanie ULg; Maquet, Pierre ULg

in Journal of Clinical Investigation (2006), 116(7), 1823-1825

Predicting the chances of recovery of consciousness and communication in patients who survive their coma but transit in a vegetative state or minimally conscious state (MCS) remains a major challenge for ... [more ▼]

Predicting the chances of recovery of consciousness and communication in patients who survive their coma but transit in a vegetative state or minimally conscious state (MCS) remains a major challenge for their medical caregivers. Very few studies have examined the slow neuronal changes underlying functional recovery of consciousness from severe chronic brain damage. A case study in this issue of the JCI reports an extraordinary recovery of functional verbal communication and motor function in a patient who remained in MCS for 19 years (see the related article beginning on page 2005). Diffusion tensor MRI showed increased fractional anisotropy (assumed to reflect myelinated fiber density) in posteromedial cortices, encompassing cuneus and precuneus. These same areas showed increased glucose metabolism as studied by PET scanning, likely reflecting the neuronal regrowth paralleling the patient's clinical recovery. This case shows that old dogmas need to be oppugned, as recovery with meaningful reduction in disability continued in this case for nearly 2 decades after extremely severe traumatic brain injury. [less ▲]

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See detailOrbitofrontal cortex involvement in chronic analgesic-overuse headache evolving from episodic migraine
Fumal, Arnaud ULg; Laureys, Steven ULg; Di Clemente, Laura et al

in Brain (2006), 129(Pt 2), 543-550

The way in which medication overuse transforms episodic migraine into chronic daily headache is unknown. To search for candidate brain areas involved in this process, we measured glucose metabolism with ... [more ▼]

The way in which medication overuse transforms episodic migraine into chronic daily headache is unknown. To search for candidate brain areas involved in this process, we measured glucose metabolism with 18-FDG PET in 16 chronic migraineurs with analgesic overuse before and 3 weeks after medication withdrawal and compared the data with those of a control population (n = 68). Before withdrawal, the bilateral thalamus, orbitofrontal cortex (OFC), anterior cingulate gyrus, insula/ventral striatum and right inferior parietal lobule were hypometabolic, while the cerebellar vermis was hypermetabolic. All dysmetabolic areas recovered to almost normal glucose uptake after withdrawal of analgesics, except the OFC where a further metabolic decrease was found. A subanalysis showed that most of the orbitofrontal hypometabolism was due to eight patients overusing combination analgesics and/or an ergotamine-caffeine preparation. Medication overuse headache is thus associated with reversible metabolic changes in pain processing structures like other chronic pain disorders, but also with persistent orbitofrontal hypofunction. The latter is known to occur in drug dependence and could predispose subgroups of migraineurs to recurrent analgesic overuse. [less ▲]

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See detailHippocampal response at training promotes insight after sleep
Darsaud, Annabelle; Balteau, Evelyne ULg; Desseilles, Martin ULg et al

in NeuroImage (2006), 31(Suppl. 1),

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See detailThe role of sleep in the consolidation of emotional memories in humans : a fMRI study
Sterpenich, Virginie; Albouy, Geneviève ULg; Boly, Mélanie ULg et al

Poster (2006)

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